DOL-OPS16-R-00015-0002.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

OPS

S-4307 200 Constitution Ave, NW Office of Procurement Services US Department of Labor

CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OROPS

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

03/14/2016 1000 ET

02/29/2016

Elvis Colbert (No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

DOL-OPS-16-R-00015

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 94 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

Washington DC 20210

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Washington DC 20210 S-4307 200 Constitution Ave, NW Office of Procurement Services

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$11.0

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

US Department of Labor

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

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UNIT PRICE

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UNIT

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QUANTITY

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SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

AMENDMENT 0002

The Department of Labor (DOL), on behalf of the Office of Worker's Compensation Programs (OWCP), has a requirement for a contractor to perform Medical Second Opinion Services for the Boston District Office in accordance with the attached Performance Work Statement (PWS).

This requirement will result in the award of a single Indefinite Delivery Indefinite Quantity

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

Kim Stepney

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

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UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

(IDIQ) contract. The period of performance will be for a base period of 12 months, with four, 12 month option periods to follow.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

94 2 of

DOL-OPS-16-R-00015/0002

Medical Second Opinion Services – Boston

SECTION B – SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS

B.1. General

The contractor shall furnish Medical Second Opinion (SECOP) services and Medical Examination services for the U.S.

Department of Labor, Office of Workers’ Compensation Programs (OWCP), Division of Federal Compensation (DFEC) Boston District Office in accordance with the terms and conditions set forth in the solicitation document (including all amendments/modifications), and the resulting contract.

B.2 Contract Type

The Government anticipates awarding a firm-fixed unit price, indefinite delivery, indefinite quantity (IDIQ) type contract for services required by this PWS. See Section B - Schedule of Supplies/Services for “estimated quantities”

B.3 Period of Performance

This contract shall be in effect for a one (1) year base period and four (4) one-year option periods and all options shall be exercised at the unilateral discretion of the Government. The anticipated periods of performances are as follows:

Base Period: 03/31/2016-03/30/2017 Option Year 1: 03/31/2017-03/30/2018 Option Year 2: 03/31/2018-03/30/2019 Option Year 3: 03/31/2019-03/30/2020 Option Year 4: 03/31/2020-03/30/2021

B.4. Minimum/Maximum Requirements

The minimum guaranteed on this contract shall not exceed one (1) during any period of performance in which actual services are not ordered or required. In addition, the total amount estimated for the maximum quantities shall not exceed the “Total Not-To-Exceed Amount(s)” identified in the Schedule of Supplies/Services.

Note: Due to the fluctuating circumstances surrounding the need for these services and because each case is unique and does not always necessitate the government to schedule SECOP services that are required by this PWS, the Government estimates the guaranteed minimum for the base and each option period shall not exceed one (1) each for SECOP, Schedule Awards only, file review only, supplemental report and follow-up report services.

B.5. Payment For “No Show/Canceled” Appointments

Government Cancellations (without notice): When the Government gives less than 24 hour notice in canceling a scheduled appointment and the physician/specialist bills for services in accordance with office policy for cancel/no show appointments, a fee up to $50 shall be paid by the Government as sole compensation for the cancelled appointment.

Claimant Cancellations (without notice): When a claimant gives less than 24 hour notice in canceling a scheduled appointment and the physician/specialist bills for services in accordance with office policy for canceled/no show appointments, a fee up to $50 shall be paid by the Government as sole compensation for the cancelled appointment.

No Show: When a claimant, without prior notice, fails to report for the scheduled appointment and the physician/specialist bills for services in accordance with office policy for canceled/no show appointments, a fee up to $50 shall be paid by the Government as sole compensation for the “no show” appointment.

NOTE: The Government will pay cancellation/no show fees directly to the SECOP contractor. Specific OWCP codes shall be supplied to the SECOP Contractor for invoicing/billing of all services including cancellations, diagnostic testing and procedures, interpretive and transportation. The use of OWCP specific codes shall be strictly prohibited outside the performance of this contract. All canceled appointments shall require documentation to support the reason of cancellation and shall be submitted with the invoice/bill for the Government’s review. The absence of the required documentation (as applicable) shall result in the non-certification of the invoice/bill and non-payment. Interpretive and transportation services also require prior Government notification and approval (when possible) and supporting documentation (as applicable). Transportation will be reimbursed at the GSA Per Diem Rate.

B.6 Payment for Necessary Supplemental Consultations, Diagnostic laboratory Tests and Diagnostic Procedures and other related services

The Contractor shall invoice/bill diagnostic testing and procedures using the appropriate CPT or HCPCS code. Any use of OWCP specific codes outside the requirements of this contract is strictly prohibited unless otherwise authorized by DFEC in writing for each incident. To reduce the chances of duplicate billing/invoicing, the contractor shall ensure no physician directly invoice/bill the government for these services.

Professional consultations, radiology procedures, diagnostic laboratory tests and other diagnostic procedures deemed necessary to complete a second opinion examination will be paid according to the OWCP fee schedule limitations provided under 20 CFR 10.805-813. Interpretive and transportation services require prior Government notification and approval (when possible) and supporting documentation (as applicable). Transportation will be reimbursed at the GSA Per Diem Rate.

All services shall be invoiced/billed and paid in accordance with the OWCP fee schedule limitations provided under 20 CFR 10.805-813 using the appropriate CPT or HCPCS code. The DFEC District office will review all reports for accuracy and viability prior to the invoice/bill being submitted for payment.

B. 7 Payment for Second Opinion Examinations, Impairment Rating Examinations, File Reviews, Supplemental Reports and Follow-Up Reports

When all medical examination and report requirements have been rendered and verified accurate, the Contractor shall submit one (1) invoice/bill for services along with a copy of the medical report to the Boston District Office. Specific OWCP codes shall be supplied to the Contractor for invoicing/billing. The use of OWCP specific codes shall be strictly prohibited outside the performance of this contract. Once the DFEC District office has reviewed the report for accuracy and viability, the invoice/bill charges shall be reviewed, verified and certified, and the invoice/bill shall be submitted for payment by the District Office. The absence of the required report documentation shall result in the non-certification of the invoice/bill and non-payment. Payment for services shall not be initiated until the Contractor has met all the reporting requirements and DFEC has deemed the report viable. Once DFEC has deemed the report viable, the invoice/bill shall be submitted in accordance with Federal Acquisition Regulation (FAR) Clause 52.232-25 Prompt Payment Act and OWCP invoicing/billing procedures. All related interpretive and transportation services require prior Government notification and approval (when possible) and supporting documentation (as applicable). All pre-approved travel cost (when applicable) will be reimbursed at the GSA Per Diem Rate.

B.8 Pricing and Estimated Quantities

The Contractor shall provide the SECOP and medical examination services, as specified elsewhere in the Schedule, at the firm fixed price per unit specified herein. All terms and conditions of the initial contract shall remain unchanged, except as where expressly and formally modified by both parties, when applicable. The following prices indicate the sole rate of reimbursement under this contract. The price is inclusive of any/all labor, indirect costs, materials, pick-up and delivery, ancillary costs and applicable fees. In addition, the total amount estimated for the maximum quantities below shall not exceed the “Total Not To Exceed Amounts” indicated below (excluding services indicated in Sections B.5 and B.6).

Base Period: 03/31/2016-03/30/2017 Item Number

Description of Supplies/Services

Minimum Quantity

Maximum Quantities

Unit Unit Price *Amount

0001 Medical Second Opinion Services

1 800 Each $ $

0002 Schedule Awards 1 200 Each $ $ 0003 Supplemental Reports 1 150 Each $ $ 0004 Follow-Up Reports 1 75 Each $ $ 0005 File Review Only 1 25 Each $ $

Total Not to Exceed Amount $

Option Period One: 03/31/2017–03/30/2018 Item Number Description of

Supplies/Services Minimum Quantity

Maximum Quantities

Unit Unit Price *Amount

1001 Medical Second Opinion Services

1 800 Each $ $

1002 Schedule Awards 1 200 Each $ $ 1003 Supplemental Reports 1 150 Each $ $ 1004 Follow-Up Reports 1 75 Each $ $ 1005 File Review Only 1 25 Each $ $

Total Not to Exceed Amount $

Option Period Two: 03/31/2018-03/30/2019 Item Number

Description of Supplies/Services

Minimum Quantity

Maximum Quantities

Unit Unit Price *Amount

2001 Medical Second Opinion Services

1 800 Each $ $

2002 Schedule Awards 1 200 Each $ $ 2003 Supplemental Reports 1 150 Each $ $ 2004 Follow-Up Reports 1 75 Each $ $ 2005 File Review Only 1 25 Each $ $

Total Not to Exceed Amount $

Option Period Three: 03/31/2019-03/30/2020 Item Number

Description of Supplies/Services

Minimum Quantity

Maximum Quantities

Unit Unit Price *Amount

3001 Medical Second Opinion Services

1 800 Each $ $

3002 Schedule Awards 1 200 Each $ $ 3003 Supplemental Reports 1 150 Each $ $

3004 Follow-Up Reports 1 75 Each $ $ 3005 File Review Only 1 25 Each $ $

Option Period Four: 03/31/2020-03/30/2021 Item Number

Description of Supplies/Services

Minimum Quantity

Maximum Quantities

Unit Unit Price *Amount

4001 Medical Second Opinion Services

1 800 Each $ $

4002 Schedule Awards 1 200 Each $ $ 4003 Supplemental Reports 1 150 Each $ $ 4004 Follow-Up Reports 1 75 Each $ $ 4005 File Review Only 1 25 Each $ $

*Total “Not to Exceed” Contract Amount (sum of all amounts)

SECTION C – PERFORMANCE WORK STATEMENT

PART 1

PERFORMANCE WORK STATEMENT

C.1.1 Purpose

This is a non-personal services contract to provide: Medical Second Opinion and Medical Examination Services (SECOP) for the Office of Workers’ Compensation, Division of Federal Employees’ Compensation (DFEC). The contractor’s employees shall remain under the contractor’s direct supervision at all times. Although the Government will coordinate directions within the scope of the contract, detailed instruction for the contractor’s employees and supervision shall remain the responsibility of the contractor. The Government also shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government.

C.1.2 Background

The Office of Workers' Compensation Programs (OWCP) is responsible for administration of the Federal Employees' Compensation Act (FECA). The Act provides for medical benefits, wage-loss replacement, survivors' annuities, and other benefits to employees of the United States or their survivors when the employee is injured or dies in the course of employment. The OWCP, through the DFEC, coordinates the activities of twelve District Offices. These District Offices have direct responsibility for processing claims. The District Office functional operations include: adjudicating incoming claims to determine eligibility for compensation payments; managing claims in which eligibility has been established; determining wage-loss compensation payments for covered disability or death; and processing payments for allowed medical and vocational rehabilitation services incurred in the treatment of injured workers covered under the Act.

Under the FECA, medical care and compensation for wage loss and for permanent physical impairment are provided to Federal employees who are injured in the performance of duty. The medical evaluation of workers who submit compensation claims is part of the adjudication and case management process.

A medical evaluation may be necessary: (1) to determine the causal relationship between work factors and the disease or injury; (2) to assess the extent and duration of the physical impairment or disability; (3) to determine the appropriateness of therapy, including some surgical procedures; or (4) to determine when recovery has occurred and a return to work is feasible.

In certain instances, the DFEC must refer a claimant to a specialist in an appropriate field for a second medical opinion. The second opinion is based on and shall include a review of appropriate claim file material, a physical or psychiatric examination of the claimant, the performance of any clinical or laboratory tests deemed necessary in the diagnostic work-up, and a narrative medical report responding to specific questions posed by a claims examiner. In addition to specific questions, the claims examiner provides a Statement of Accepted Facts (SOAF) which contains the information concerning events, working conditions and employment data accepted as factual by the DFEC. As such, the SOAF is the framework which the physician must use in answering the specific questions and in developing the evaluation report.

The important elements of this service contract shall be the delivery of a quality, viable medical report(s), the verification and replication of impairment ratings by a reliable, certifiable and standardized process and the timeliness of scheduling medical reports. To be acceptable, the medical reports shall present comprehensive, unequivocal, unbiased and well-reasoned narrative opinions that are consistent with objective medical evidence or testing, physical or psychological findings that are consistent to the framework of the SOAF or provide a clear comprehensive, well-reasoned opinion disputing any of the medical conditions outlined in the SOAF that are unsubstantiated with any medical findings, and that address all questions posed by the claims examiner. The timely scheduling of appointments for examinations shall be maintained within the timeframes set forth in this solicitation and within the government’s acceptance of the number of physicians available by “required” specialty and within the designated Metropolitan Statistical Area (MSA) to limit the inconvenience to FECA claimants. The timely delivery of a quality, viable medical reports contributes to prompt and accurate adjudication of outstanding medical and compensation issues.

C.1.3 Objective

The objective of this requirement shall enable the government to procure Medical Second Opinion (SECOP) and Medical Examinations, Schedule Awards, Supplemental Reports, Follow-up Reports, File Reviews and related services in order to facilitate the timely and accurate adjudication of claims filed by DFEC claimants covered by the Boston District Office.

C.1.4 Scope

The contractor shall be responsible for providing the technical, management and functional activities necessary to perform all work associated with medical second opinion and examination services in order to facilitate the timely scheduling of appointments, provide adequate and sufficient numbers of qualified physicians/specialists within the geographical area and to provide the timely and accurate delivery of a quality, viable medical report(s).

C.1.5 Type of Contract

The Government anticipates awarding a firm-fixed unit price, indefinite delivery, indefinite quantity (IDIQ) type contract for services required by this PWS. See Section B - Schedule of Supplies/Services and Prices/Costs for “estimated quantities”.

C.1.6 Contract Term

The contract term will be for a one (1) year base period and four one (1) year option periods. All option periods will be exercised at the unilateral discretion of the Government and the total performance duration shall not exceed five (5) years, six (6) months, when all options are exercised. The effective date will begin from date of contract award. See Section B for anticipated performance periods.

C.1.7 Recognized Holidays

The following are recognized Federal holidays and the contractor is not required to perform services on these days including scheduling appointments and the providers direct medical examination services:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

C.1.8 Hours of Operation:

The contractor shall be responsible for conducting business, between the hours of 8:00 am to 5:00 pm local time (established by the time zone of the DFEC District Office), Monday thru Friday. No direct medical examinations may take place on a Federal holiday. The Contractor shall at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this SOW when the Government facility is not closed for the above reasons.

C.1.9 Canceled/No show Appointments

When the Government cancels a scheduled appointment with at least 24 hour notice to the contractor or to the examining physician, no payment shall be made and no liability will be incurred by the Government.

When the Government or claimant cancels a scheduled appointment with less than 24 hour notice and/or does not attend an appointment and the providers office policy requires the payment for no show or canceled appointment, the payment terms of Section B will apply.

All canceled appointments shall require prior government notification and the inclusion of specific codes and documentation when invoicing/billing for services. The OWCP will provide specific codes for use when invoicing/billing for these services and the contractor will be responsible for ensuring each invoice/bill is proper for payment and includes the time, date, contact person notified and the reason for the cancellation. For payment information, see Section B.

Note: The absence of the required invoice/billing information may result in the non-certification and/or non-payment for services. The use of OWCP specific codes outside the performance of this contract shall be strictly prohibited.

C.1.10 Performance Work Statement

The DFEC Boston District Office services include providing the services identified throughout the solicitation, PWS, Task 5, Technical Exhibits I and II the resulting contract. All days referred to in this Section and elsewhere are calendar days, unless otherwise specified.

A. Summary/Overview. The Contractor shall perform all related supervisory and project management/control activities to provide services required by the PWS and Task Areas 1 through 6 (See Part 5 for specific tasks).

o Task Area 1 – Contract-Level and Task Order Management o Task Area 2 – Operational Support Services for OWCP/DFEC District Office.

o Task Area 3 – Qualified and Appropriate Medical Specialists.

o Task Area 4 – SECOP Reports to include Follow-up Reports and Supplemental reports.

o Task Area 5 – Scheduling of Appointments for Examinations.

o Task Area 6 – Additional Support Services for DFEC District Office.

C.1.11 Second Opinion Examinations, Impairment Rating Examinations, File Reviews, Supplemental Reports and

Follow-Up Reports.

The contractor shall provide sufficient and adequate numbers of specialists/physicians in order to provide second opinion examinations, impairment rating examinations, file reviews, supplemental reports and follow up reports in accordance with the PWS and Task 5. The DFEC Boston District office will review all reports for accuracy and viability prior to the invoice/bill being submitted for payment. Please see Section B “Schedule of Supplies/Services and Prices/Costs” for specific invoicing/billing requirements.

C.1.12 Necessary Supplemental Consultations, Diagnostic Laboratory Tests and Diagnostic Procedures

The contractor shall provide sufficient and adequate numbers of specialists/physicians in order to provide professional consultations, diagnostic laboratory tests and other diagnostic procedures deemed necessary to complete a second opinion examination obtain objective medical evidence for the physician to render a comprehensive, unequivocal, unbiased and well-reasoned narrative opinion that is consistent with objective medical evidence or testing; physical or psychological findings that are consistent to the framework of the SOAF; provide a clear comprehensive, well-reasoned opinion disputing any of the medical conditions outlined in the SOAF that are unsubstantiated with any medical findings and that address all questions posed by the claims examiner in accordance with the PWS and Task 5.6 “Additional Support Services for DFEC District Office”.

C.1.13 Claimants Covered and Work to be Performed.

The contractor shall be capable of providing medical second opinion and examinations services to DFEC claimants of whom reside within the states covered by the Boston District Office MSA (states: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont).

The services include medical second opinion and examination services which encompasses the timely scheduling of appointments, a review of appropriate claim file material, a physical or psychiatric examination of the claimant, the performance of any clinical or laboratory tests deemed necessary in the diagnostic work-up, and the delivery of a quality, viable medical report(s) that address all questions posed by the claims examiner. In addition, other services include schedule award, follow-up reports, supplemental reports and file reviews.

The contractor must also have the ability to schedule timely medical second opinion and examination services and at all times maintain an adequate and sufficient network of qualified physicians to meet contract requirements for the maximum quantities indicated in Section B. Adequate and sufficient numbers of qualified physicians/specialists shall be achieved when the contractor has demonstrated the ability to ensure that no one (1) physician/specialist performs more than one-third (1/3) of the required services per annum in any one MSAs, and the physicians/specialists are geographically located within the Boston District Office MSA to meet contract requirements.

The first four (4) categories are "required” medical specialties. The physicians identified are for informational purposes only and do not commit the Government to any particular mix of specialties under the contract.

• orthopedic surgery

• otolaryngology

• psychiatry

• neurological surgery

• allergy and immunology

• colon and rectal surgery

• dermatology

• emergency medicine

• medical toxicology

• Internal medicine

• cardiovascular disease

• clinical cardiac electrophysiology

• clinical and laboratory immunology

• endocrinology, diabetes, and metabolism

• gastroenterology

• hematology

• infectious diseases

• interventional cardiology

• medical oncology

• nephrology

• pulmonary disease

• rheumatology

• sleep medicine

• nuclear medicine

• obstetrics and gynecology

• occupational medicine

• medical toxicology

• ophthalmology

• physical medicine & rehabilitation

• plastic surgery

• radiation oncology

• radiology, diagnostic

• surgery

• hand surgery

• vascular surgery

• thoracic surgery

• urology

The first four (4) categories are "required specialties”. The estimates provided above are for informational purposes only and do not commit the Government to any particular mix of specialties under any contract.

Geographic Availability of Physician/Specialists within the Region to be Served

The OMB has defined MSAs for each of the states in the District at www.omb.gov and all Prospective contractors are encouraged to visit the site to ensure they have reviewed the most recent version of the MSA geographical jurisdictional listing prior to the due date for receipt of proposals and prior to submitting a proposal in response to the solicitation.”

The primary area of coverage within the Boston District Office includes the states of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont’s MSA. These are the primary areas where the contractor must provide qualified, sufficient and adequate numbers of physicians/specialists. However, there may be cases when a claimant who resides within the primary MSA may be better serviced by the MSA’s border state. The contractor must also provide information on how the services of each category of medical specialty will be delivered throughout the area to be served. Particular attention and detail must be provided to the first four (4) “required” specialties and the identified MSAs.

Per OMB’s information located at www.omb.gov, the primary area covered by the Boston District Office may include geographical areas that are considered either “urban” or rural”. In areas identified as “rural”, claimants may be required to travel beyond the maximum travel radius identified in Task 5 and the PWS. When these conditions exists, the contractor shall propose a detailed and alternative narrative approach that will demonstrate their ability to meet all other contract requirements in a timely, economical and efficient method and with the least inconvenience to the claimant and risk to the government. The information must be clearly identified in the proposal under Factor 4 (Geographic Availability of Physician/Specialists within the Region to be Served) and the Quality Control Plan (QCP) and it must address how the contract would be executed in areas other than the described urban areas.

Note: OWCP/DFEC requires physician/specialists resources to be able to meet with claimants face-to-face and therefore, physician/specialists resources must be available in sufficient numbers and geographically distributed as to cover the needs of the claimants living in these areas. Limited exceptions can be made only when the claimant lives in a remote area outside the MSA, or with the express permission of the COR.

C.1.14 Performance/Delivery Schedule: The contractor shall perform all elements of the second opinion services within the time frames described below, Task 5 and Technical Exhibit 2.

C.1.15 Contractor Records Retention. Contractor shall retain a copy of each referral package for ninety (90) days after submitting a completed report in case of need for a supplemental or follow-up report or for re-performance under the terms of Section L, below. Contractor shall retain a copy of each completed report for twelve (12) months after the date submitted to OWCP.

C.1.16 Correction or Re-performance under the Warranty of Services Clause, (FAR 52.246-20). Should any delivered report require clarification, correction, completion, or re-performance under Clause 52.246-20 Warranty of Services, such will take the form of an addendum report. The Contractor shall submit an acceptable addendum report within http://www.omb.gov/ twenty-one (21) days and without additional charge, except for such additional diagnostic procedures as may be required.

A. If there are 5 or more addendum requests per quarter to the same physician, the Contractor is required to perform an internal quality review as specified by DFEC. If the physician is unable to correct his/her deficiencies, the physician will be removed from use.

C.1.17 Security, Confidentiality and Care of Claimant Medical Records and DFEC Files. DFEC files, claimant medical records and related materials remain the property of the U.S. Department of Labor, and no property right in them is conferred on the physician or medical facility providing service. All DFEC files and related materials, as well as, the reports which are generated in fulfillment of this contract must be treated in a confidential manner and may be made available only to persons who have a need for them in order to provide services under this agreement. The Contractor shall:

(1) assure that no excerpts are taken from any compensation file except as necessary to accomplish the purposes of this contract;

(2) assure that no medical case history be used for publication of any paper or book or in lectures without written permission of the Director of the Office;

(3) assure that, when not in actual use, all DFEC files and related material in the Contractor's possession be kept in locked storage, accessible only to those individuals who have a need for them;

(4) assure that no DFEC files, related materials, medical second opinion reports, or facsimiles thereof, are released to any claimant, attorney, employing agency or other party at interest without express written permission of the Contracting Officer; and

(5) assure that all DFEC files and related materials supplied to the contractor are returned to DFEC at the same address and according to the same schedule indicated in Section C.1.12 and C.1.15(G) for return of Reports.

(6) assure that copies of DFEC files or related materials which may have been retained by the Contractor, and copies of reports retained under the requirement at Section C.1.15.K, are destroyed by burning, shredding or another technique that will preserve claimant confidentiality and privacy.

C.1.18 Training for Participating Physician/Specialists. In coordination with the COR, the Contractor shall ensure all participating physicians/specialists are familiar with the requirements of the PWS and Task 5 (as applicable). Also, see Task 5 Area 6.

C.1.19 Training for OWCP District Office Staff. In coordination with the District Office COR, the Contractor shall prepare all training materials and provide training to District Office Staff. See Task 5 Area 6.

C.1.20 Quality Control: The contractor shall develop and maintain an effective quality control program to ensure medical examination services and reports are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of any defective service or report. The contractor shall ensure that all reports conform to the DFEC requirements to meet a viable report and that all impairment ratings are verified using a standardized, unbiased and certifiable method. The contractor’s quality control program shall be the means by which assurance that work complies with the requirement of the contract. The Quality Control Plan shall be delivered with the contractors’ proposal. The Contractor shall submit final QCP for the

Government’s acceptance 10 days after contract award. After acceptance of the quality control plan the contractor shall receive the contracting officer’s acceptance in writing of any proposed change to his QC system.

C.1.21 Quality Assurance: The Government shall evaluate the contractor’s performance under this contract. This oversight is primarily focused on what the Government shall do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards shall be applied, the frequency of surveillance, and the minimum acceptable defect rate(s).

C.1.22 Privacy

Portions of information disclosed during the performance of this task are protected by the provisions of the Privacy Act of 1974; therefore, all personnel assigned to this Contract shall be required to take proper precautions to protect the information from disclosure. The Contractor shall ensure that any disclosure or breach of private, personal or medical information shall be immediately reported to the Contracting Officer and the National Office COR within one (1) hour.

The Contractor shall have a process in the event of a breach or disclosure that also includes corrective action. The Contractor shall submit a privacy disclosure or breach of personal information plan to the government in their proposal.

C.1.23 Personal Information and Privacy

The contractor shall provide personal information and privacy support to ensure compliance to the Privacy Act and other Federal Privacy related policies including, but not limited to, OMB Memorandum M-06-16, Protection of Sensitive Agency Information, and M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information. This support shall include the review and evaluation of the Privacy Impact Assessments (PIAs) for all systems containing DOL sensitive and PII information. The review shall ensure that the systems comply with the appropriate regulations pertaining to personally identifiable information (PII). The contractor shall evaluate the current PIA methodology and tracking system; and provide recommendations to make the processes and/or system more efficient and effective. The contractor shall evaluate their existing Departmental Privacy related policies and procedures to ensure they comply with federal Privacy related policies. Where the Contractor’s departmental policies and procedures do not comply, the Contractor shall perform the necessary updates/revisions to bring the documents and/or system into compliance as requested by the Contracting Officer or COR at no additional cost to the government. The contractor shall also ensure that all identified privacy vulnerabilities and areas of noncompliance have been documented and resolution tracked.

The Contractor shall ensure that its second opinion medical examination services solution maintains conformance to the most recent DOL implementation of Federal information security guidelines, currently defined as:

• The Freedom of Information Act, as amended (5 USC 522), which provides for the disclosure of information maintained by Federal agencies to the public, while allowing limited protection for privacy.

• The Privacy Act of 1974, as amended (5 USC 522a), including the Computer Matching and Privacy Act of 1988 (Public Law 100-503).

• The Computer Security Act of 1987 (Public Law 100-235), which established minimum security practices for Federal computer systems.

• The Federal Information Security Management Act of 2002, which established the requirement for all information systems operated by or on behalf of the United States Government to be certified and accredited as satisfying the minimum information security requirements established by statute, regulation, and National Institute of Standards and Technology (NIST) standards and guidance materials.

• OMB Circular A-130, Management of Federal Information Resources, which provides instructions to Federal agencies on how to comply with the fair information practices and security requirements for operating automated information systems.

• OMB Memorandum M-07-16, Safeguarding Against the Breach of Personally Identifiable Information, May 22, 2007.

• OMB Memorandum M-06-19, Reporting Incidents Involving Personally Identifiable Information and Incorporating the Cost for Security in Agency Information Technology Investments, July 12, 2006.

• OMB Memorandum M-06-16, Protection of Sensitive Agency Information, June 23, 2006.

• OMB Memorandum M-06-15, Safeguarding Personally Identifiable Information, May 22, 2006.

• FIPS PUB 199, Standards for Security Categorization of Federal Information and Information Systems.

http://csrc.nist.gov/publications/fips/fips199/FIPS-PUB-199-final.pdf

• FIPS PUB 200, Minimum Security Requirements for Federal Information Systems.

http://csrc.nist.gov/publications/fips/fips200/FIPS-200-final-march.pdf

• NIST Special Publication (SP) 800-53, Recommended Security Controls for Federal Information Systems.

http://csrc.nist.gov/publications/nistpubs/800-53-Rev2/sp800-53-rev2-final.pdf

• US DOL Computer Security Handbook (DOL’s implementation of NIST SP 800-53). (Reference Attachment 25 - Computer Security Handbook 3.0)

• DLMS – 9 – Chapter 1200, DOL Safeguarding Sensitive Data Including Personally Identifiable Information (Reference Attachment 26 - Department of Labor Manual Series (DLMS) 9 Chapter 1200)

C.1.24 Privacy Responsibilities

(a) The Contractor shall ensure that every employee completes all mandated Federal security training requirements prior to the employee’s first day of work under the second opinion medical examination services contract unless the Government provides a signed waiver agreement. The Government will provide annual security training to all on-site contractors required for these services.

(b) The Contractor shall ensure that all information and reports generated under the terms of this contract are, and shall always remain, the property of the Government.

(c) The Contractor shall protect the Personally Identifiable Information (PII) of all claimants, providers, and Government employees from unauthorized disclosure.

(d) The Contractor shall use a Government-approved reporting mechanism, tool or form to notify the Government of all security incidents, disclosures, breaches, disasters involving Personally Identifiable Information (PII) within one (1) hour of becoming aware of the incident. This written notification shall describe the security incident, disclosure, breach or disaster in detail and state the measures taken to protect the confidentiality, integrity and availability of OWCP information. The contractor’s plan shall be included in the proposal and the Quality Assurance Plan.

(e) The Contractor shall take no action until the OWCP National Office and Contracting Officer is notified and provides direction. The District Office COR is not authorized to respond or act on behalf of the OWCP National Office on security incidents, disclosures, breaches or disasters involving PII.

(e) The government shall approve the Contractors resolution to the incident.

(f) The contractor shall be responsible for any liability resulting for the security incident, disclosure or breach involving a claimant’s PII, including financial harm to the government.

http://csrc.nist.gov/publications/fips/fips199/FIPS-PUB-199-final.pdf http://csrc.nist.gov/publications/fips/fips200/FIPS-200-final-march.pdf http://csrc.nist.gov/publications/nistpubs/800-53-Rev2/sp800-53-rev2-final.pdf

C.1.25 Ownership

All products and deliverables developed under this PWS and contract shall be the property of the U.S. Government and Department of Labor, Office of Workers’ Compensation Programs.

C.1.26 Commitment To Protect Sensitive Information

The Contractor shall not release, publish, or disclose sensitive information to unauthorized personnel, and shall protect such information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information: 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records).

The Contractor shall not use or disclose any case information for study, research or any other circumstance without the express written approval of the Contracting Officer.

C.1.27 Contracting Officer Representative (COR):

The resulting contract will be monitored by the following individual COR’s: (Note: TBD at time of award)

District Office COR National Office COR – N/A

(Note: When N/A is indicated for National Office COR, the Contracting Officer reserves the right to retain and execute such COR duties until otherwise designated and authorized in writing.)

The District Office and National Office COR shall be identified by separate letter. Each COR monitors all technical aspects of the contract and assists in contract administration. Both CORs is authorized to perform the following functions:

assure that the Contractor performs the technical requirements of the contract: perform the oversight necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, monitor Contractor's performance and notifies both the Contracting Officer and Contractor of any deficiencies. A letter of designation issued to both the District Office COR and the National Office COR will be issued stating their responsibilities and limitations. A copy will also be forwarded to the Contractor outlining those responsibilities and limitations, especially with regard to changes in cost or price, estimates or changes in delivery dates. The District Office or National Office CORs are NOT authorized to make changes to any of the terms and conditions of the resulting contract. Changes shall only be made by the Contracting Officer.

C.1.28 Contractor Personnel and Medical Specialists: The contractor shall provide sufficient personnel, and Medical Specialists both in numbers and qualifications to perform all work associated with the PWS and Task 5. The contractor’s employees shall remain under the contractor’s direct supervision at all times and each contract service provider (medical specialists) shall be accountable solely to the contractor who, in turn is responsible to the Government for ensuring all services are provided in accordance with the contracts terms and conditions.

C.1.29 Employee/Physician/Specialists Conduct

Contractor employees and subcontractors shall at ALL times conduct themselves in a professional manner and shall not reflect discredit upon the United States Government, the Department of Labor and the Office of Workers’ Compensation Programs.

C.1.30 Removal or disapproval of Employees, Physicians and Specialists for Misconduct or Security Reasons. The Government shall, at its sole discretion, remove or disapprove any contractor employee physician or specialists from performing a U.S. Department of Labor contract requirement including but not limited to, inability to perform a thorough examination and/or report, misconduct, bias, appearance of conflict of interest, or safety/security reasons.

Removal or disapproval does not relieve the Contractor of the responsibility to continue providing the services required by the contract. The Contracting Officer shall provide the contractor with a written explanation to support any request to remove an employee or service provider.

C.1.31 Disapproval of Physicians/Specialists. The Government shall, at its sole discretion, disapprove a Physician or Specialists from performing a U.S. Department of Labor contract requirement including but not limited to, inability to perform a thorough examination and/or report, misconduct, bias, appearance of conflict of interest, or safety/security reasons. Disapproval does not relieve the Contractor of the responsibility to continue providing the services required by the contract. The Contracting Officer shall provide the contractor with a written explanation to support its decision.

PART 2

DEFINITIONS & ACRONYMS

2.1 Acronyms

CO – Contracting Officer

COR - Contracting Officer’s Representative: A representative from the requiring activity assigned by the Contracting Officer to perform surveillance and to act as liaison to the contractor

DOL - Department of Labor

EFT – Electronic Funds Transfer

FAR – Federal Acquisition Regulation

IDIQ –Indefinite Delivery Indefinite Quantity

IT – Information Technology

OASAM – Office of the Assistant Secretary for Administration and Management

OMB - Office of Management and Budget

PWS – Performance Work Statement

POP – Period of Performance

Quality Control - Those actions taken by a contractor to control the performance of services so that they meet the requirements of the PWS.

Quality Assurance - Those actions taken by the Government to assure services meet the requirements of the Performance Work Statement. See Technical Exhibit 1 “Performance Requirements Summary”

SOW – Statement of Work

OFFICE OF WORKERS’ COMPENSATION PROGRAMS ACCEPTED

DEFINITIONS & ACRONYMS

DFEC – Division of Federal Employees’ Compensation

Fee Schedule – An OWCP specific five digit code used for billing and reporting medical second opinion and examination services and procedures performed by physicians.

Geographic Location - The states served by the District Office which include several population centers described by the *Metropolitan Statistical Area.

*MSA – Metropolitan Statistical Areas - The Population centers served within the United States.

*Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont

OWCP - Office of Workers’ Compensation Programs

Provider – individual, group or facility providing medical second opinion examinations and services.

“Required” categories: The Governments best estimate of the types of physicians or medical specialties required for performance of medical second opinion and examination services within the MSA.

*Orthopedic surgery, psychiatry, otolaryngology and neurological surgery

SECOP - Medical Second Opinion and Examination Services

WCMBP – Workers Compensation Medical Bill Processing

Types of Causal Relationship:

Under the FECA, an injury or disease may be considered as employment-related in any one of several ways. The FECA contains no provision for apportionment, and the Office will pay for all medical and compensation expenses due to impairments which result from an employment injury.

A. Direct Causation. This type of relationship exists when the injury or factors of employment result in the claimed condition through a natural and unbroken sequence. Acute trauma such as from a fall exemplifies this type of causal relationship.

Direct causation may be identified in both traumatic injuries and occupational diseases. However, the amount and sophistication of the medical documentation necessary to establish this relationship in claims for occupational diseases are usually greater because of the multifactorial etiologies and clinical complexities of some of these diseases.

B. Aggravation. This type of relationship exists when a preexisting condition (not necessarily employment-related) is intensified or exacerbated by an employment-related injury or factor. If this type of causality is identified by the consultant, it is imperative that it be categorized as temporary or permanent.

(1) Temporary aggravation involves an exacerbation of a pre-existing condition which will last for a finite period of time, after which the employee returns to his or her baseline physical status. For instance, an acute asthmatic attack is triggered in an employee known to have asthma by the exposure to formaldehyde fumes in the work place.

In such a case, compensation is payable only for the period of exacerbation established by the medical evidence and not for any disability caused by the underlying disease.

(2) Permanent aggravation constitutes an exacerbation of an underlying condition which persists indefinitely or produces irreversible anatomical and/or physiologic changes so that the employee does not return to his or her previous status. Identification of this type of causality requires thoughtful evaluation of the medical documentation in the case file.